HomeMy WebLinkAboutPermit Mechanical 2014-3-28 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON
Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00658
www.spdngfield-or.gov permitcenter @spdngfield-or.gov
PROJECT STATUS: Issued ISSUED: 03/28/2014 EXPIRES: 09/24/2014
- STATUS DATE: 03/28/2014 APPLIED: 03/28/2014
SITE ADDRESS: 5952 G ST,Springfield,OR 97478 SCOPE: Mechanical Only •
ASSESOR'S PARCEL NO: 1702342200405 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Wood fireplace insert
OWNER: LECOQUE STEVEN M&JUDITH H Phone Number:
ADDRESS: 5952 G STREET
SPRINGFIELD OR 97478 •
CONTRACTOR INFORMATION 1
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor THERMAL RESOURCES INC CCB 161946 10/29/2014 541-343-1131
INSPECTIONS REQUIRED
Inspections •
2140 Pellet,Gas, Fireplace or Wood Wood Stove: After Installation.
Stove
2300 Rough Mechanical Rough Mechanical: Prior to Cover
2999 Final Mechanical Final Mechanical: When all mechanical work is complete.
By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the
Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO
OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further
certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree •
to ensure that all required inspections are requested at the proper time,that each address is readable from the street,that the
permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during
construction. .
;. .teillgtel- ALP. ��/a / L�
Ow r Contractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth NOTICE:
in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK
0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT
calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR
number for the Oregon Utility Notification •
Center is 1-800-332-2344). ANY 180,DAY PERIOD.
Springfield Building Permit 3/28/2014 10:07:10AM Page 1 of 1
SPRINGFIELD'S - CITY OF SPRINGFIELD
225 Fifth St
t EGON TRANSACTION RECEIPT 569969914,0R 97477
y 541-726-3753
811-SPR2014-00658
www.springfeld-or.gov 5952 G ST permitcenter @spdngfield-or.gov
RECEIPT NO: 2014000675 RECORD NO: 811-SPR2014-00658 DATE:03/28/2014
e C• Pi ION atl. kitt:•'i-'1144t4ftgl>- } `:. s..' ACCOUNT'CODE/TRANS'CODE-, _ ^AMOUNTiDU
First Appliance Fee 224-00000-425604 1006 80.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60
Technology fee(5%of permit total) 100-00000-425605 2099 4.00
TOTAL DUE: 93.60
P.
AYMENTmTYR PAY-OR .CnswElt aARSON -? OMMENTS �'- AMOUNTPPAID
Check LECOQUE STEVEN M&JUDITH H 93.60
8794
TOTAL PAID: 93.60
•
•
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Mechanical Permit Application DEPARTMENT USE ONLY
a„ SPRINGFIELD
Oat
ti 111 SPRiNGT+IE7 D R `GO t °: Perlriit no SPfCzol cJ Oo6S�b
+�. xis �a'1:-3 FAXs OREGON z Yj/
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225 Filth Street ♦ Springfield.OR 97477 ♦ PH(541)726 3753 • FAX(541)726-3689 - OREGON Date: Z53 f L1
This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180 (lays of issuance or if work is
suspended for ISO days.
CATEGORY OF CONSTRUCTION FEE SCHEDULE
XResidential ❑ Government ❑ Commercial Residential Qty. enst Total
ca. cost
JOB SITE INFORMATION AND LOCATION First Appliance $80.00 $
Job site address: 5 5_a G S I-, - Furnace/burner including ducts and cents
City:SY-t J �di State:'e_ ZIP: 974 Up to Il)Ok tl' tJthr. 818.50 $
Over I00k 13111/hr. $22.00 $
Reference: -Fax lot.:
Heaters/stoves/vents
DESCRIPTION OAF WORK Unit heater ___ $18.50 5
_ �1 b KWIC o71U� ( 1/2wc.A. wood/pellet/gas stove/flue / $42.00 $
Repair/alter/add to hearing appliance!
refrigeration unit or cooling system/ $80.00 $
PROPERTY OWNER absorption system
Name: Q�j.e_ _. _. du _ e! • Evaporated cooler $14.50 $
- V Vent fan with one duct/appliance vent $10.00 $
Address: a Cr
Flood with exhaust and duct 514.50 S
City:5 �t� StateOIZ , Z1P(1.l�7�
t�� Floor furnace including vent $80.00 $
Phone: S\t{t -' --(-1--Soq Fax: - - Cas piping --
One to four outlets $7.50 $
E-mail: _ `:. �i'1
!3. . s �,
This installation is P eing made on property owned by me or a Additional outlets(each)
. $4.50 S
member of my immediate family. and is exempt from licensing Air-handling units, including ducts
requirements under ORS 701.010 Up to 1 0.000 CFNI $12.00 $
Signature: ALA - faiww1p u uti • Over 10.000 MI $22.00 $
(,.NTRACTOR INSTALLATII Compressor/absorption system/heat pump
Business name: f {�per,, Up to 3 hp/100k iiru $18.50 $
S (11ADA m� t us
lip to IS hp/500k BTU $32.00 $
Address: 16-7.80. 74-k Up to 30 hp/I,000 BTU $47.50 $
il x-.tc .,vvQ State:Oa_ ZIP: 1 oa Up to 50 hp/1,750 BTU $62.50
PhoneStl- 3y3—1131 Fax: - - Over 50 hp/1.750 BTU $104.50 $
E-mail: Incinerators
Domestic incinerator 522.50 5
CCB license no.: I (-Q ) 1 L is \ Commercial
11 -- ---...........-
Print name:��Qyy�( c�a Cap.S Y�td4(> tsi sk tS Enter total valuation of mechanical system
and installation costs$
Signature: —..----
Enter fee based on valuation of mechanical system.etc. _$
Miscellaneous fees Items Cost Total
ea. cost
Reinspection $80.00 5
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(u ncl assed) $14.50 $
Each additional inspection: (I) $80.00 S
APPLICANT USE
(A)Enter subtotal of above fees(or enter set
mininuun fee of $80.00) $
(B)Investigative fee(equal to[A]) $
(C)Enter I2'%surcharge(.12 x IA+131) $
(D) Seismic fee. I%(.01 x [A]) $
(I:.)Technology Fee(5%of[AI) $
440-2545-J(-I/1/2013/CONI) TOTAL fees mid surcharges(A through E): $ 7307? -